What is the interpretation of a urinalysis (UA) with dark yellow color, cloudy appearance, negative glucose, trace bilirubin, negative ketones, specific gravity of 1.025, large blood presence, abnormal pH of 5.5, protein level of 100 mg/dL, urobilinogen level of 0.2 mg/dL, negative nitrite, and 1+ leukocytes?

From the Guidelines

The patient's urinalysis results indicate a potential urinary tract infection (UTI) or other urinary system issue, and they should seek prompt medical attention for further evaluation and possible treatment with antibiotics, as suggested by the 2023 European Association of Urology guidelines on the management of non-neurogenic male lower urinary tract symptoms 1. The presence of several abnormal findings, including 3+ blood, 100 mg/dL protein, trace ketones, and 1+ leukocytes, is particularly concerning and warrants immediate attention.

• The urine's dark yellow color, cloudy appearance, and low pH of 5.5, along with a high specific gravity of 1.025, indicate concentrated urine, which may be a sign of dehydration or other underlying issues.
• The combination of blood, leukocytes, and protein in the urine strongly suggests inflammation or infection in the urinary tract, which is consistent with the guidelines' recommendation for urinalysis to identify UTIs, proteinuria, haematuria, or glycosuria 1. Key findings that support the need for prompt medical attention include:
• 3+ blood in the urine, which is a significant abnormality
• 100 mg/dL protein, indicating potential kidney function issues
• 1+ leukocytes, suggesting an inflammatory response
• Trace ketones, which could indicate metabolic issues or dehydration
• Low pH of 5.5, indicating acidic urine Until medical evaluation, the patient should:
• Increase water intake to help flush the urinary system
• Avoid caffeine and alcohol, which can irritate the bladder
• Be prepared for possible urine culture to identify any bacterial infection and subsequent treatment with antibiotics, as guided by the latest urology guidelines 1.

From the Research

Urinalysis Results

The provided urinalysis results show the following abnormalities:

• Color UA POC: Dark Yellow
• Appearance UA POC: Cloudy
• Blood UA POC: Large (3+)
• PH UA POC: 5.5
• Protein UA POC: >=300 mg/dL (100)
• Leukocytes UA POC: 1+

Interpretation of Results

According to 2, a positive result for protein on dipstick urinalysis should be evaluated in conjunction with other clinical and laboratory data. The presence of blood in the urine (hematuria) should always include dipstick analysis and microscopic examination of urine.

• The cloudy appearance of the urine could be due to precipitated phosphate crystals in alkaline urine or pyuria, as stated in 3.
• The strong odor of the urine may be the result of a concentrated specimen rather than a urinary tract infection, as mentioned in 3.
• The presence of leukocytes in the urine (pyuria) could be an indication of a urinary tract infection or renal parenchymal inflammation, as discussed in 4.

Possible Causes and Associations

The abnormalities in the urinalysis results could be associated with various conditions, including:

• Urinary tract infection (UTI): The presence of leukocytes, nitrite, and cloudy appearance could indicate a UTI, as mentioned in 3 and 4.
• Kidney disease: The presence of protein, blood, and leukocytes in the urine could be indicative of kidney disease, as discussed in 2 and 4.
• Diabetes: The presence of glucose in the urine could be an indication of diabetes, as mentioned in 2.

Further Evaluation

Further evaluation and testing may be necessary to determine the underlying cause of the abnormalities in the urinalysis results, including:

• Microscopic examination of urine
• Measurement of plasma glucose levels
• Renal function tests
• Urine culture and sensitivity testing, as mentioned in 3 and 4.